RT Book, Section
A1 Timek, Tomasz A.
A1 Fann, James I.
A2 Yuh, David D.
A2 Vricella, Luca A.
A2 Yang, Stephen C.
A2 Doty, John R.
SR Print(0)
ID 1104590332
T1 Mitral Valve Pathophysiology
T2 Johns Hopkins Textbook of Cardiothoracic Surgery
YR 2014
FD 2014
PB McGraw-Hill Education
PP New York, NY
SN 978-0-07-166350-2
LK accesssurgery.mhmedical.com/content.aspx?aid=1104590332
RD 2024/04/19
AB The  normal  mitral  valve  annulus  is  a  saddle-shaped  structure  with  3:4  ratio  of  the  anterior–posterior  to  commissure–commissure  distance.Mitral  stenosis  is  usually  a  result  of  rheumatic  fever,  and  valvular  pathology  represents  antigen  cross-reactivity  from  Group  A  streptococcus  resulting  in  valvulitis,  myocarditis,  or  pancarditis.Fibroelastic  deficiency  and  Barlow  disease  are  the  predominant  forms  of  degenerative  mitral  valve  disease  leading  to  mitral  regurgitation.  Fibroelastic  deficiency  is  found  in  older  patients  whereas  congenitally  excessive  valve  tissue  seen  in  younger  patients  is  observed  with  Barlow  valve.Chordal  rupture  is  the  most  common  etiology  of  mitral  regurgitation  in  degenerative  mitral  valve  disease.Ischemic  mitral  regurgitation  (IMR)  is  associated  with  a  localized  left  ventricular  infarct  with  subsequent  chamber  remodeling  and  perturbation  in  the  subvalvular  apparatus.  Functional  mitral  regurgitation  (FMR)  is  associated  with  end-stage  dilated  cardiomyopathy.Both  FMR  and  IMR  are  characterized  by  subvalvular  remodeling  and  annular  dilation.Leaflet  remodeling  may  contribute  to  the  pathophysiology  and  severity  of  both  IMR  and  FMR.Annular  dilation  and  perturbed  leaflet  coaptation  tend  to  be  symmetric  in  FMR  and  asymmetric  in  IMR.